TY - JOUR
T1 - Infection Pressure in Men Who Have Sex with Men and Their Suitability to Donate Blood
AU - Van Bilsen, Ward P.H.
AU - Zaaijer, Hans L.
AU - Matser, Amy
AU - Van Den Hurk, Katja
AU - Slot, Ed
AU - Schim Van Der Loeff, Maarten F.
AU - Prins, Maria
AU - Van De Laar, Thijs J.W.
N1 - Funding Information: Financial support. This study was financed by the Research and Development Foundation of the Public Health Service of Amsterdam and a Product and Process Development Cellular Products grant (PPOC 15-04) of Sanquin. Funding Information: Author contributions. T. J. W. L., K. H., H. L. Z., and M. P. are responsible for the study design. M. F. S. L. and M. P. supervised data collection for MSM, and E. S. and T. J. W. L. supervised data collection for donors. T. J. W. L. was responsible for laboratory testing. W. P. H. B. performed the statistical analysis under supervision of A. M. and M. P.. All authors contributed to the interpretation of the results, writing of the manuscript, and providing intellectual feedback. All authors have seen and approved the final submitted version of the manuscript. Acknowledgments. The authors gratefully acknowledge the Amsterdam Cohort Studies (ACS) on HIV Infection and AIDS, a collaboration between the Public Health Service of Amsterdam, the Academic Medical Center of the University of Amsterdam, the Sanquin Blood Supply Foundation, Medical Center Jan van Goyen, and the HIV Focus Center of the DC-Clinics. It is part of the Netherlands HIV Monitoring Foundation and financially supported by the Center for Infectious Disease Control of the Netherlands National Institute for Public Health and the Environment. The authors thank all ACS participants and blood donors for their contribution. On behalf of the authors, we also thank Alexandra Kovaleva and the research nurses of ACS for their contributions to data collection, Udi Davidovich for his valuable input on study design and interpretation of results, and Anders Boyd for his statistical advice and input. Publisher Copyright: © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2019/3/5
Y1 - 2019/3/5
N2 - Background Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood. Methods We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19). Results Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P <.001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P <.001). Conclusions IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.
AB - Background Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood. Methods We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19). Results Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P <.001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P <.001). Conclusions IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.
KW - blood donation
KW - deferral policy
KW - infection pressure
KW - men who have sex with men
UR - http://www.scopus.com/inward/record.url?scp=85062422325&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062422325&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30052873
U2 - https://doi.org/10.1093/cid/ciy596
DO - https://doi.org/10.1093/cid/ciy596
M3 - Article
C2 - 30052873
SN - 1058-4838
VL - 68
SP - 1001
EP - 1008
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
ER -